Onchocerciasis in Anambra State, Southeast Nigeria

clinical and psychological aspects and sustainability of community directed treatment with ivermectin (CDTI)

Evaristus C Mbanefo, Christine I Eneanya, Obioma C Nwaorgu, Victor M Oguoma, Moses O Otiji, Bernice A Ogolo

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

BACKGROUND: A cross-sectional study was performed to determine the psychological impact of onchocerciasis, and assess sustainability of the decade-old community directed treatment with ivermectin (CDTI) in Ayamelum Local Council, Anambra State, Southeast Nigeria.

METHODS: Skin manifestations assessed using the rapid assessment method (RAM) in 894 subjects from 13 communities selected by multi-stage sampling were classified based on the anatomical sites affected. Focus group discussions and in-depth interviews were used to obtain information on the psychological impacts and sustainability of the CDTI programme. Qualitative data were summarised while quantitative data generated were analysed using charts and tables.

RESULTS: Anatomical distribution showed a preponderance of onchodermatitis on the limbs (the most exposed parts of the body) and buttocks (an area considered 'private'), thus revealing some reasons for the psychological impacts of the skin disease and the psychosocial inclination of the victims. Itching (40%) and onchocercal skin manifestations (OSDs) (34.3%) were identified as the most troublesome signs and symptoms, while the most worrisome consequence of onchocerciasis was social seclusion (or stigmatisation) (34.3%). Focus group responses revealed the persistence of psychological impacts on the victims, affecting almost all facets of their lives. The CDTI programme has performed creditably well when assessed using the sustainability indicators, yet there are still challenges in the areas of coverage, monitoring, resources, and participation. A 'quick-win' was identified whereby the CDTI chain could be utilised to deliver other health interventions.

CONCLUSION: It is recommended that onchocerciasis control programmes should include aspects that would address its psychosocial impacts and threats to the sustainability of the CDTI programme.

Original languageEnglish
Pages (from-to)573-577
Number of pages5
JournalPostgraduate Medical Journal
Volume86
Issue number1020
DOIs
Publication statusPublished - Oct 2010
Externally publishedYes

Fingerprint

Onchocerciasis
Ivermectin
Nigeria
Psychology
Skin Manifestations
Focus Groups
Stereotyping
Buttocks
Pruritus
Human Body
Skin Diseases
Signs and Symptoms
Extremities
Cross-Sectional Studies
Interviews
Health

Cite this

Mbanefo, Evaristus C ; Eneanya, Christine I ; Nwaorgu, Obioma C ; Oguoma, Victor M ; Otiji, Moses O ; Ogolo, Bernice A. / Onchocerciasis in Anambra State, Southeast Nigeria : clinical and psychological aspects and sustainability of community directed treatment with ivermectin (CDTI). In: Postgraduate Medical Journal. 2010 ; Vol. 86, No. 1020. pp. 573-577.
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title = "Onchocerciasis in Anambra State, Southeast Nigeria: clinical and psychological aspects and sustainability of community directed treatment with ivermectin (CDTI)",
abstract = "BACKGROUND: A cross-sectional study was performed to determine the psychological impact of onchocerciasis, and assess sustainability of the decade-old community directed treatment with ivermectin (CDTI) in Ayamelum Local Council, Anambra State, Southeast Nigeria.METHODS: Skin manifestations assessed using the rapid assessment method (RAM) in 894 subjects from 13 communities selected by multi-stage sampling were classified based on the anatomical sites affected. Focus group discussions and in-depth interviews were used to obtain information on the psychological impacts and sustainability of the CDTI programme. Qualitative data were summarised while quantitative data generated were analysed using charts and tables.RESULTS: Anatomical distribution showed a preponderance of onchodermatitis on the limbs (the most exposed parts of the body) and buttocks (an area considered 'private'), thus revealing some reasons for the psychological impacts of the skin disease and the psychosocial inclination of the victims. Itching (40{\%}) and onchocercal skin manifestations (OSDs) (34.3{\%}) were identified as the most troublesome signs and symptoms, while the most worrisome consequence of onchocerciasis was social seclusion (or stigmatisation) (34.3{\%}). Focus group responses revealed the persistence of psychological impacts on the victims, affecting almost all facets of their lives. The CDTI programme has performed creditably well when assessed using the sustainability indicators, yet there are still challenges in the areas of coverage, monitoring, resources, and participation. A 'quick-win' was identified whereby the CDTI chain could be utilised to deliver other health interventions.CONCLUSION: It is recommended that onchocerciasis control programmes should include aspects that would address its psychosocial impacts and threats to the sustainability of the CDTI programme.",
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Onchocerciasis in Anambra State, Southeast Nigeria : clinical and psychological aspects and sustainability of community directed treatment with ivermectin (CDTI). / Mbanefo, Evaristus C; Eneanya, Christine I; Nwaorgu, Obioma C; Oguoma, Victor M; Otiji, Moses O; Ogolo, Bernice A.

In: Postgraduate Medical Journal, Vol. 86, No. 1020, 10.2010, p. 573-577.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Onchocerciasis in Anambra State, Southeast Nigeria

T2 - clinical and psychological aspects and sustainability of community directed treatment with ivermectin (CDTI)

AU - Mbanefo, Evaristus C

AU - Eneanya, Christine I

AU - Nwaorgu, Obioma C

AU - Oguoma, Victor M

AU - Otiji, Moses O

AU - Ogolo, Bernice A

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N2 - BACKGROUND: A cross-sectional study was performed to determine the psychological impact of onchocerciasis, and assess sustainability of the decade-old community directed treatment with ivermectin (CDTI) in Ayamelum Local Council, Anambra State, Southeast Nigeria.METHODS: Skin manifestations assessed using the rapid assessment method (RAM) in 894 subjects from 13 communities selected by multi-stage sampling were classified based on the anatomical sites affected. Focus group discussions and in-depth interviews were used to obtain information on the psychological impacts and sustainability of the CDTI programme. Qualitative data were summarised while quantitative data generated were analysed using charts and tables.RESULTS: Anatomical distribution showed a preponderance of onchodermatitis on the limbs (the most exposed parts of the body) and buttocks (an area considered 'private'), thus revealing some reasons for the psychological impacts of the skin disease and the psychosocial inclination of the victims. Itching (40%) and onchocercal skin manifestations (OSDs) (34.3%) were identified as the most troublesome signs and symptoms, while the most worrisome consequence of onchocerciasis was social seclusion (or stigmatisation) (34.3%). Focus group responses revealed the persistence of psychological impacts on the victims, affecting almost all facets of their lives. The CDTI programme has performed creditably well when assessed using the sustainability indicators, yet there are still challenges in the areas of coverage, monitoring, resources, and participation. A 'quick-win' was identified whereby the CDTI chain could be utilised to deliver other health interventions.CONCLUSION: It is recommended that onchocerciasis control programmes should include aspects that would address its psychosocial impacts and threats to the sustainability of the CDTI programme.

AB - BACKGROUND: A cross-sectional study was performed to determine the psychological impact of onchocerciasis, and assess sustainability of the decade-old community directed treatment with ivermectin (CDTI) in Ayamelum Local Council, Anambra State, Southeast Nigeria.METHODS: Skin manifestations assessed using the rapid assessment method (RAM) in 894 subjects from 13 communities selected by multi-stage sampling were classified based on the anatomical sites affected. Focus group discussions and in-depth interviews were used to obtain information on the psychological impacts and sustainability of the CDTI programme. Qualitative data were summarised while quantitative data generated were analysed using charts and tables.RESULTS: Anatomical distribution showed a preponderance of onchodermatitis on the limbs (the most exposed parts of the body) and buttocks (an area considered 'private'), thus revealing some reasons for the psychological impacts of the skin disease and the psychosocial inclination of the victims. Itching (40%) and onchocercal skin manifestations (OSDs) (34.3%) were identified as the most troublesome signs and symptoms, while the most worrisome consequence of onchocerciasis was social seclusion (or stigmatisation) (34.3%). Focus group responses revealed the persistence of psychological impacts on the victims, affecting almost all facets of their lives. The CDTI programme has performed creditably well when assessed using the sustainability indicators, yet there are still challenges in the areas of coverage, monitoring, resources, and participation. A 'quick-win' was identified whereby the CDTI chain could be utilised to deliver other health interventions.CONCLUSION: It is recommended that onchocerciasis control programmes should include aspects that would address its psychosocial impacts and threats to the sustainability of the CDTI programme.

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KW - Fear

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KW - Filaricides/therapeutic use

KW - Humans

KW - Ivermectin/therapeutic use

KW - Male

KW - Middle Aged

KW - Nigeria/epidemiology

KW - Onchocerciasis/drug therapy

KW - Perception

KW - Pruritus

KW - Rural Health Services

KW - Self Concept

KW - Stereotyping

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